This search term somebody used to find my website is the inspiration for this post: How many times can a woman have a C-section?
This is something that really needs to be understood, and possibly there needs to be more research. Because of ACOG’s change of guidelines, many doctors and hospitals are now refusing to allow a woman to have a VBAC, insisting instead on an “elective” repeat Cesarean. (How elective can it be, when that’s the only choice given her??) But some women have medically-indicated repeat C-sections, and some women actually freely choose repeat surgery (sometimes thinking they must, because “their bones are too small” or some such thing).
Someone I met once said that her doctor said it was okay to have up to five C-sections. My question (which I suppose I’ll have to get answered sometime) is, what happens if she gets pregnant after that? [innocent smile] Well, she’d have to have yet another C-section, or have a VBAC. But the real question isn’t “how many CAN you have?” but is more “how many is it SAFE to have?”
I argue that if it’s not medically necessary, then it’s not safe to have one at all, because of the higher risk of complications to both baby and mother from this major abdominal surgery, as well as the risk of future problems related to a pregnancy in a scarred uterus — and the risks go up with every surgery. However, C-sections in America are fairly safe — they carry only 5-7 times the risk of death to the mother as vaginal birth. (That fact and others are listed here.) The risk to the mother and any future babies is also increased, usually exponentially, with every additional C-section. These risks generally are related to the placenta and include accreta (the placenta grows through the uterine lining), previa (the placenta grows over the opening of the uterus), and abruption (the placenta detaches from the uterine wall partially or completely, prior to the birth of the baby. Maternal hemorrhage and hysterectomy are also increased.
So, the best way to avoid a repeat C-section is to avoid a primary one! Not all doctors and not all hospitals are created equal — you need to make sure that your doctor and hospital both have low C-section rates — I cannot stress enough that your care provider and labor support team (including L&D nurses at the hospital) will greatly affect your labor and birth. Having a doula is also proven to reduce the incidence of C-sections, while improving your labor experience. Keeping yourself healthy and low-risk will also reduce the likelihood of having a C-section. Educating yourself is necessary.
But, if you’ve had one C-section, then here’s the abstract of a recent study about the likelihood of a successful VBAC. It shows that the rate of complications related to VBACs (including uterine rupture and dehiscence) went down after the first successful VBAC. So, if you’ve already had a successful VBAC, and now all of a sudden your doctor or hospital won’t allow another one, you may need to ask for the medical reasoning, especially in light of the latest evidence. Here is a link to a listing of research done on VBACs. It is a “sound bite” version, if you will, of the research — provided so that you can get the name of the study and the journal it appeared in, so that you can look up the full article with greater ease.
But what if you’ve already had more than one C-section? Can you still have a vaginal birth? Yes! Check out the following links (in no particular order):
- a blog post written by a woman after her first vaginal birth… which was after four C-sections (it’s the last story on the page, written Feb. 2005
- a website from the UK, with some stories of vaginal birth after two or more C-sections, plus links to other research on VBAMCs (vaginal birth after multiple Cesareans)
- a birth story of a VBA3C (vaginal birth after three Cesareans)
- an excellent website, with a very long page on C-sections, including VBACs, VBAMCs, etc.
Check out my other posts about C-sections, for more information, as well as links to some really cool videos!
Filed under: C-section, birth choices | Tagged: baby, breech, C-section, caesarean, cesarean, HBAC, health, hemorrhage, home birth, hospital birth, placenta, placenta accreta, placenta previa, placental abruption, pregnancy, pregnant, ubac, vaginal birth, vba2c, vba3c, VBAC, vbamc
My dumb friend who is french and has a huge forehead says you can only have up to 3 c-sections please tell him his a ******* retard.
[Edited to delete an objectionable word.]
It’s possible that different doctors have different preferences and protocols when it comes to this question. A doctor may have told him that he will do no more than 3 C-sections. The risk to the mother, and to any future offspring, is definitely greater the more C-sections you do, so it is wise to avoid them unless necessary. In fact, many doctors take that into consideration when recommending a C-section — if they know the woman wants a large family, they will apprise her of the risks involved.
Now, whether or not your friend is dumb, is an entirely different matter; but I am not the one to pass judgment on his mental abilities, regardless of his appearance or background.
I have had 3 c-sections before and am going to try for a vba3c next time around. It is good to know that there are others out there who are helping spread the word about the risks of c-sections. It is time we start educating women about how wonderful our bodies really are and how we can birth naturally without major surgery.
thanks.
i had three caesarean section and i want to get pregnancy with my new hushand i would like to know is it safe to get pregnancy and have caesarean section again i want to give him a child my children are three years apart and the third one is four years apart so can i have another baby and it is safe to have another caesaren
Nancy,
The risk of having any complications after three c-sections is low, but higher than if you had never had any C-sections at all. You may have individual risks, depending on how healthy you are and the skill of your doctor. In addition to whatever risks are inherent in any C-section, because of your multiple C-sections you will be at a higher risk of maternal hemorrhage and/or hysterectomy (removal of your uterus). You and your baby are also at higher risk of having problems with the placenta (the organ that nourishes and provides oxygen for your baby). These problems include a greater incidence of the placenta growing over the opening of the uterus, and the placenta growing on and into the scar of the uterus (which increases your risk of hemorrhage, hysterectomy, and other complications). “Increased risk” does not mean that you will definitely have these problems — most women don’t — but it is something to seriously consider and balance your desire to have a child with your new husband, with the risks involved.
Linked to you, after you made a comment on my blog. Seems like you and I are on the same page.
I sent your link for this post on to someone considering a VBAC after 2 c-sections. Just thought you’d like to know.
I’ll be writing a follow-up to the husband/doula debate soon. Should be fun!
HI I HAVE HAD 3 C SECTION AND NOW DUE FOR MY FOURTH. BUT I AM VERY SCARED, DO U THINK ITS THAT RISKY FOR ME…. PLEASE HELP
Both vaginal birth and Cesarean are generally very safe procedures. The biggest risk of VBAC is a uterine rupture, and that is more likely to cause problems for the baby than you — but the overall risk of uterine rupture is very small, particularly if you avoid drugs which induce or augment labor (although the risk may rise with every repeated incision). C-sections tend to cause several problems for the baby (the exact reasons are unknown — perhaps some babies are born a little too early, even if they’re at “term”; elective C-sections do not have any labor contractions which may benefit the baby — perhaps by stimulating his breathing skills and ability; and there is benefit to being squeezed through the birth canal — the fluid in the lungs is more effectively drained). One of the big problems with C-section is that the risk of certain problems occurring in a future birth are increased, and these problems include the placenta growing into the uterus, particularly at the incision site, which may cause maternal hemorrhage and necessitate a hysterectomy.
The relative risks of C-section are much higher than vaginal birth, and this goes up with every repeated C-section; but the absolute risk remains low. Most women do not suffer long-term effects from C-sections, but of course, if it happens to you, it’s 100%.
You said you are very scared — it may be your intuition telling you something is not quite right, and I would urge you to explore that possibility, and try to get to a place of peace before you proceed with your plans. There are women who have had successful vaginal births after having had multiple Cesareans, and if you feel led to go that way, while being fearful of a repeat C-section, you may have good reason for that, even if you can’t quite put your finger on why. Stories abound of people listening to their intuition, or having a miraculous or near-miraculous intervention that saved their lives. Just recently, I read the story of a man who was working in some factory by a furnace, and had a sudden and overwhelming need to go to the bathroom; right after he walked away from the furnace to relieve himself, the furnace exploded, killing several people and injuring even more. He would have been one of the dead ones, had he not “happened” to walk away.
I cannot make the choice for you — I can only give you information to help you make your choice. It may be that you do need a C-section, but perhaps not quite on the day that it is scheduled. Perhaps you may need to wait until you go into labor naturally, or even just wait a week or two to let your baby mature more. Quite likely, everything will go just fine, regardless of what you choose. Explore your options and then choose which one is best for you.
I really appreciate this site and its boldness for spreading truth.
I have had 6 unnecessary c-sections. They have all been low-transverse and healed well. My first was due to malposition which could have easily been changed if I would have been “allowed” to move. I was dilated and effaced completely with no induction. My 2nd c-section was due to the nurse “accidently” rupturing my membranes when I was only dilated to 7 and the baby not coming right away. How stupid of me to allow them to cut me again and not just wait. I had this baby over four years after my first. There was no reason at all to operate. My doctor was distressed!
My 3rd c-section was about 2 years later and was elective due to scare tactics. With my fourth pregnancy I was much more educated in the field of child birth and VBAC and was completely prepared to have this baby naturally. Everything went great until I went to the hospital. I was treated like a criminal preparing to commit murder. I dilated to 10 on my own, but was still harassed and harassed until finally forced to have a c-section. During this operation my fascia was not put back together and I had a bulge the sixe of a small water balloon below my navel. I still suffer from this operation that was performed over 8 years ago. My 5th c-section was performed after finding a doctor who I felt supported me. I dilated again to 10. The baby was even descending into the birth canal. I had a nurse that was extremely nervous and told me I was taking too great of a risk. She frightened the dr and he demanded that I have another c-section. During this c-section the doctor nicked the main artery that connects my left fallopian tube to my uterus. I almost died from blood loss in this operation. I needed at least 2 or more transfusions and I had to spend the entire night in the ICU without my baby boy. It was horrible!!! That was considered the “safe” option….a c-section! My 6th c-section was in April 07. It was planned and I had a wonderful birthing experience. The doctor treated me human and cared very much for me. He told me that my uterus looked great and I was ready for baby #7. He knew we wanted a big family. That was in Germany.
So, here I am now…I am in TN. I am almost 30 weeks pregnant and still have not even seen a OBGYN. This is the first time I feel very frightened about the medical system. I have been in contact with a Dr. via phone and email. She is a Dr/Midwife and we are seriously considering a Home birth. This is where I am now thanks to the abuse I have received in the hospitals. I am a woman wanting to have a baby. I want to be treated like a human not like an atomic bomb waiting to go off. I have read and read and read both sides…I know the risks. I am concerned about the safe delivery of my baby. But I have been frightened away from medical staff…There is so much more to my story. But, it would be too long to write here. I have been abused emotionally and physically. I feel I have been violated and have lost my body to a system…an evil system that believes that having a baby is a medical condition. Having a baby is not a medical condition. It is a normal, natural, God-given process that man has perverted and taken control over. Allow woman to just have their baby in a peaceful and safe environment. Leave us alone! If there is an emergency, we are thankful to have the medical staff…but until then, please let us be and let us give birth! The doctor does not need an enema every time he has to use the rest room and women do not need any interventions or inductions to have their babies!!!!!
Sincerely, A woman who just wants to give birth not have an operation,
Angela
PS. A decision made out of fear is no decision at all!!!!!